Critical Choices: End-of-life registry is a vital resource

March 24, 2014

Autonomy is important for most residents of the Mountain State. We would rather make decisions for ourselves than put important choices in the hands of attorneys, hospitals or even relatives. That may be why West Virginia is one of only six states to have a program like e-Directive Registry, from the West Virginia Center for End-of-Life Care.

Because of this registry, nearly 11,000 forms regarding advanced directives were submitted last year -and are now available to doctors and nurses who might not otherwise know those patients' wishes. Documents available to be registered include Do Not Resuscitate orders, living wills, medical power of attorney forms and Physicians Orders for Scope of Treatment, or POST, forms. With these tools, a patient can be confident that, should he become unable to speak for himself, anyone involved in treatment will know his wishes and ensure they are carried out.

It may be tempting to believe this is a step that can be put off until a patient has reached an advanced age. In fact, many of the most painful and notable cases involving end-of-life care disputes surround much younger individuals. A conflict between family members and a hospital became so complex and politically charged that it ensnared the Texas Legislature this year. That patient was 33 years old.

But here in West Virginia, according to Dr. Alvin Moss, director of the WVCELC and of the Center for Health Ethics and Law at West Virginia University, 62 hospitals, 20 hospices and 110 nursing homes have opted in to the system that gives them access to the registry. That number must grow, as should the number of residents who take advantage of the peace of mind offered by such a service.

"This is the opportunity to make a self-determination, rather than to rely on somebody else to make that medical decision for you at the end of your life; that's the most critical aspect of it," Thom Stevens, a volunteer at the center and president of the health-care advocacy firm Government Relations Specialists LLC, told a reporter.

Much has been made about what a gift it is for families when funerals have been planned in advance. Clear, formal instructions for end-of-life care available to both families and doctors at all types of medical facilities might be an even greater gift.